CNS causes of vertigo include brainstem vascular disease, arteriovenous malformations, tumor of the brainstem and cerebellum, multiple sclerosis, and vertebrobasilar migraine (Table 8–2)
Vertigo of central origin often becomes unremitting and disabling
The associated nystagmus is often nonfatigable, vertical rather than horizontal in orientation, without latency, and unsuppressed by visual fixation
ENG is useful in documenting these characteristics
There are commonly other signs of brainstem dysfunction (eg, cranial nerve palsies; motor, sensory, or cerebellar deficits in the limbs) or of increased intracranial pressure
Auditory function is generally spared
The underlying cause should be treated